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After-hours primary health services up for review

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The AMA has welcomed the Government’s recently announced independent review of after-hours primary health care services. The review will be headed by Professor Claire Jackson, with recommendations to be provided to the Government by 31 October 2014.

This latest review was one of the recommendations to Government following Professor John Horvath’s Review of Medicare Locals to assess their performance and effectiveness. Among other things, he recommended that the Government should “review the current Medicare Locals’ after-hours program to determine how it can be effectively administered”.

The AMA, in its Submission to the Review of Medicare Locals, highlighted the ineffectiveness of Medicare Locals in implementing after-hours funding arrangements, leaving a number of GPs previously committed to after-hours care disenfranchised, and adding to the red tape and compliance costs for general practice.

The AMA supported a restoration of after-hours funding via the Practice Incentive Payment program, with supplementary programs developed to target identified gaps in service delivery at the local level. 

The review is focusing on the key principles for after-hours primary health care services, including the role of GPs and general practices in delivering after-hours services, and delivery challenges in rural and remote regions.

There will be opportunity to comment on the PIP after-hours incentive and on the role played by MLs in funding after hours care, as well as the after-hours GP helpline and the potential use of video conferencing to provide after-hours care. It is also looking at possible funding alternatives for rural and remote regions.

The AMA is preparing a submission to the Review of After-Hours Service Delivery, working with both the AMA Council of General Practice and the AMA Rural Medical Committee. 

Comments received to date from member representatives to date highlight the need for funding to be directed to those GPs and practices that are providing a genuine after-hours service to their patients.

Also, given the poor remuneration for after-hours services and the disparity in service accessibility, a single solution is unlikely to address the barriers to the provision of after-hours services and provide appropriate patient access. 

The AMA’s Position Statement on Out-of-Hours Primary Medical Care outlines what we think an after-hours primary care model should look like. Among others things, it would need to:

•         provide appropriate remuneration for the provision of clinically required services;

•         ensure continuity of care;

•         be driven by well-defined clinical need;

•         be locally appropriate and conform to appropriate professional standards; and

•         prove its effectiveness.

The AMA has also met with Professor Jackson in the lead up to the provision of our submission.

Because the timeline for the review is so short, any AMA members who would like to contribute comments or ideas should contact the AMA immediately to ensure their views can be considered.